BEVERLY HILLS (MI) -- No, you didn’t read that wrong. Bet you thought that the old dude must have fat-fingered the ‘r’ and hit the letter ‘t’ next to it in error, but you would be mistaken. Smack dab in the middle of the craziest week in college basketball known as “March Madness” each and every 4th year medical school student in America participated in “Match Madness.” It’s an agonizing process that, at least to those involved, is far more dramatic and traumatic than its hoops equivalent could ever possibly be.

Think I’m overhyping the situation?

Envision yourself showing up for “Match Day” and your Dean hands you an envelope, the contents of which will determine where you will spend the next four or five years as a resident, honing your craft as an M.D. The sum total of your twenty years of education is in that envelope…and you can’t open it until 12:00 noon!

Pretty intense, huh?

You have no idea.

The-Future-Dr. Younger Swampette (aka our younger daughter Caitlin) went thru this high-pressure experience on Friday, March 16th along with 36,000 other 4th years, competing for only 26,000 available residencies. The other 10,000 who don’t match will have to try their luck again next year…with the added bonus of starting to pay off their student loans immediately.

The mating dance that is “Match Day” commences in the fall of 4th year for Med School students. They are allowed to do a few thirty day “away rotations” in their chosen specialty. Caitlin is going to be an Orthopedic Surgeon, so she did an Ortho rotation in September in Chapel Hill at the UNC Medical Center and then turned right around and did another one during October at Northwestern Medical Center in downtown Chicago. The advantage to doing an “away rotation” is that the med student gets to see first-hand what the residency program at that particular hospital is like. And, of course, the hospital staff gets to see the student and watch them work, quiz them and find out what makes them tick for an entire month.

Next came the interview process. The med students apply for residencies at the hospitals where they would like to end up, based on their respective specialty and geographic preference. Here, Northwestern takes it a step further: they won’t even interview you unless you went to Med School there or did an “away rotation.” The student submits a CV as well as three letters of recommendation from professors or MDs with whom they have worked or done research. It’s purely a numbers game: most residency programs will interview sixty, eighty or sometimes one hundred students for a mere six to ten openings. So, if you do the math, in order to statistically insure a match, a med student should go on a minimum of twelve interviews. Caitlin wasn’t about to leave anything to chance--she applied to sixty programs and did sixteen interviews.

One of the humorous parts of the interview process was a question that came up at virtually every program she visited:

How did you become a Red Sox fan?

In her profile, Caitlin included that fact that she likes to watch Red Sox games in her free time. Invariably, the person asking the question was themselves a Sawx fan, so she had an instant (if rather small) leg up on her competition in their eyes.

After doing the interviews, the real math begins. The med student ranks the programs where they interviewed; likewise, the hospitals rank the students. The National Residency Matching Program (NRMP) then uses Ken Pomeroy’s famous ‘predictor algorithm’ that works so well in college hoops to “match” student with program.

Caitlin had a “Sweet Sixteen” that included the aforementioned UNC and Northwestern, plus Cincinnati, Harvard, UC-San Diego, George Washington, Brown, Tufts, The Cleveland Clinic, The Milwaukee Medical Center and The Mayo Clinic.

Women Orthopedic Surgeons are hard to come by and some programs are making a concerted effort to change that; others prefer to remain an “Old Boys Club.” Caitlin took this factor into consideration, along with the strength, reputation and location of the program when compiling her ranking list.

In between her interviews and the date by which she had to submit her final rankings, a few things helped to influence her decisions. She heard from someone she knew and trusted who had done an “away rotation” at Harvard that residents there got very little hands-on surgical experience. In addition, Harvard has a definite reputation as an “Old Boys Club” as a scan of the current resident roster would attest. Up until then, Harvard had been her #1.

Then she got a note from the Chief Resident at Northwestern, thanking her for interviewing and doing her “away rotation” there and expressing the hope that she would rank them highly because they planned to do so with her. Caitlin immediately dismissed the note, saying “I bet they sent one of those letters to everybody that they interviewed.” Her mother and I assured her that it wasn’t a Commie plot and that the Chief was trying to send her a subtle message--we really want you!

It would be the only such letter that she would receive.

A few weeks before “Match Day” she drew up her rankings. Caitlin’s “Final Four” consisted of:

Northwestern
Harvard
Cleveland Clinic
UC-San Diego

The Monday before “Match Day” some of the interminable pressure on the 4th years was released. At 1:00PM on that day, they received an email from the NRMP that let them know if they had matched or not. Those who did not match can then participate in “The Scramble” where remaining openings are filled on a first-come, first-served basis. One of Caitlin’s classmates who didn’t match in Ortho “scrambled” and got an open Radiology residency at Providence. The days leading up to that Monday, a normally confident Caitlin started to doubt herself. “What if I don’t match?” Her mother and I tried to reassure her that it was only a matter of “where” and not “if” but I don’t think she believed us until she actually read that email.

“Match Day” for Wayne State University Medical School was held at the Motor City Casino (kind of appropriate, no?) WSU has the largest single-campus Med School graduating class in the country--288 students. The festivities started at 11:00AM with speeches, awards and a vocal group that had the unenviable task of singing when everyone in the room was watching the clock, waiting for 12:00 to finally arrive. WSU Med School Dean Valerie Parisi went thru the WSU Med School matching stats -- 96% of the class had matched! Everyone in the room then did a champagne toast and the envelopes were passed around.

Dean Parisi had a whistle that she would blow when the clock struck high noon. The NRMP is very vigilant about matches not being released before that time and everyone across the country in all five time zones opens their envelopes simultaneously.

Imagine.

Twenty years in one envelope.

Dean Parisi blew her whistle; Caitlin opened her envelope and immediately broke out into a big smile and tears simultaneously and hugged her fiancé Richie.

Caitlin had gotten her first choice, Northwestern.

She would be one of four women out of ten 4th year med students chosen for their Orthopedic Surgery residency program.

GEORGE WASHINGTON
Students choose from two distinct GW campuses — Foggy Bottom and Mount Vernon. Both are located in historic and prestigious Northwest Washington, DC residential neighborhoods. With 9,700 undergraduate students, GW was founded almost 200 years ago and is named after the first President of the United States. GW stands as one of the nation's premier academic institutions with dozens of famous political, social, science, liberal arts, medical and professional graduates to its credit. Fellow members of the A10 Conference. Nickname is the Colonials.

Congrats, my son is in his junior year of pre-med at UD and also wants to be an Orthopedic (or is it Orthopaedic?) surgeon. He wants to attend Ohio U Osteo Med School and has an interview set up in May with the Admissions Director.

I can only imagine the suspense your daughter went through and what my son has to look forward to.